[Multidisciplinary pelvic floor team: 5 year experience.] / Unidad funcional multidisciplinar de suelo pélvico: experiencia de 5 años.

INTRODUCTION: Pelvic floor dysfunction (PFD) is expressed by many different symptoms that can affect pelvic floor organs. These symptoms can appear alone or associated. The involvement of different organs and the wide variety of symptoms we have to deal with, has become teamwork essential for diagnosis and treatment of PFD. Currently, multidisciplinary pelvic floor teams are essential when dealing with PFD. OBJECTIVE: The main objective of the article is to analyze characteristics and pathologies of the patients discussed during these multidisciplinary meetings. MATERIAL AND METHODS: This is a descriptive study. Patients followed in the multidisciplinary pelvic floorteam at Galdakao-Usansolo Hospital were recruited. We analyzed the patients discussed at the meetings from January 2014 until March 2019. RESULTS: We recruited 55 patients. 89.09% were female and the mean age of the analyzed patients was 55.36 years. The most frequent reasons for medicalconsultation were pelvic floor prolapses in female (22.45%) and pelvic floor pain in male (33.33%). Association between symptoms occur in 78.18% of the patients.41.82% of patients were referred to more than 2 specialists and 21.82% needed associated treatments. CONCLUSIONS: Pelvic floor dysfunction is manifested by a combination of  symptoms which need different specialists, not only for diagnosis, but also for treatment. This is why multidisciplinary teams have become important for the management of pelvic floor disfunction.

INTRODUCCIÓN: La disfunción del suelo pélvico se presenta de múltiples formas y se manifiesta con síntomas que afectan a diferentes órganos del suelo pélvico. Estos síntomas pueden aparecer aislados o asociados entre sí, implicando así a diferentes especialidades a la hora del diagnóstico y tratamiento. Los comités multidisciplinares se han convertido en una herramienta imprescindible en el manejo de la patología del suelo pélvico. OBJETIVO: El objetivo principal es estudiar las características de la patología que presentan los pacientes abordados en el Comité Funcional Multidisciplinar de Suelo Pélvico (CFMSP).MATERIAL Y MÉTODOS: Estudio descriptivo transversal de los pacientes abordados en el CFMSP del Hospital de Galdakao-Usansolo desde 2014 hasta marzo de 2019. RESULTADOS: En el comité se abordaron 55 pacientes, de las cuales el 89,09% fueron mujeres. La edad media fue de 55,36 años. El motivo de consulta másfrecuente fue el prolapso de órganos pélvicos (22,45%) en la población femenina y el dolor (33,33%) en la población masculina. El 78,18% presentaba más de unsíntoma asociado. Los pacientes que requirieron ser derivados a más de 2 especialidades supuso el 41,82% y el 21,82% de los pacientes precisaron más de una modalidad de tratamiento. CONCLUSIONES: La patología del suelo pélvico se manifiesta como asociación de síntomas que requieren la implicación de diferentes especialistas para el diagnóstico y tratamiento. Es el motivo por el que las unidades multidisciplinares son cada vez más necesarias en el abordaje integral de la patología del suelo pélvico.

Testicular dislocation: An atypical case and review of the literature.

Traumatic dislocation of testis is a rare event. We report a case of traumatic testicular dislocation in a 27-year-old patient presenting a right inguinal lump in a context of acute alcohol abuse with transient global amnesia. There was a tender mass in the right inguinal region and right hemiscrotum. He ascertained a previous scrotal position of both testes. The Doppler ultrasound confirmed the diagnosis of a dislocated right testis in right inguinal canal and surgical reduction and orchidopexy was performed. It is necessary to perform a complete physical examination in a trauma patient, early detection and management are both essential to preserve normal spermatogenic function.

Characteristics and outcomes of ureteroscopic treatment in 2650 patients with impacted ureteral stones.

PURPOSE: To describe stone-free rates and complications of ureteroscopic treatment for impacted compared with non-impacted ureteral stones and evaluate predictive variables for impaction. METHODS: The Clinical Research Office of the Endourological Society prospectively collected 1 consecutive year of data from 114 centers worldwide. Patients eligible for inclusion were patients treated with ureteroscopy for ureteral stones. Patient characteristics, treatment details, and outcomes were compared with regard to stone impaction. Logistic regression analyses were conducted to explore predictive variables for ureteral stone impaction and to analyse the effect of impaction on outcomes. RESULTS: Of the 8543 treated patients, 2650 (31%) had impacted and 5893 (69%) non-impacted stones. The stone-free rate was 87.1% for impacted stones, which is lower compared with 92.7% for non-impacted stones (p < 0.001). Intra-operative complication rates were higher for impacted stones (7.9 versus 3.0%, p < 0.001). Significantly higher ureteral perforation- and avulsion rates were reported in the impacted stone group compared with the non-impacted stone group. No association between stone impaction and post-operative complications could be shown. Female gender, ASA-score >1, prior stone treatment, positive pre-operative urine culture, and larger stones showed to be predictive variables for stone impaction. CONCLUSIONS: Ureteroscopic treatment for impacted stones is associated with lower stone-free rates and higher intra-operative complication rates compared with treatment for non-impacted stones. The predictive variables for the presence of stone impaction may contribute to the identification of stone impaction during the diagnostic process. Moreover, identification of stone impaction may aid the selection of the optimal treatment modality.